The Hidden Dangers: Superabsorbent Polymer Beads as a Cause of Bowel Obstruction in Children

Abstract

Introduction

Superabsorbent polymer (SAP) bead ingestion poses a challenge for children, sometimes necessitating surgical intervention due to bowel obstruction. We present a literature review and in vitro experiment to explore strategies to contract enlarged SAP beads.

Methods

A literature review (PubMed, Google Scholar) was also conducted to identify cases of SAP bead-induced bowel obstruction in children. Diagnostic strategies, treatments, and outcomes were abstracted. We then conducted an in vitro experiment where SAP beads were grown in a simulated intestinal environment (normal saline, 37°C) and exposed to potentially therapeutic agents with different osmolarities to explore size reduction mechanisms.

Results

We identified 87 patients (14.0 ± 4.5 mo) from 45 studies with bowel obstruction following SAP bead ingestion. Abdominal radiograph (73.5%) visualized the SAP bead in 5.6% of instances, whereas ultrasound (57.1%) identified the SAP bead in 85.7% of instances. 85.6% of patients required enterotomy (71.4%). Most postoperative complications were reoperations (16.3%) to remove additional beads. One mortality was recorded. In the in vitro experiment, the osmotic laxative GoLYTELY contributed to a 35.17% reduction in the size of expanded SAP beads within 24 h, demonstrating its efficacy alongside hyperosmolar solutions such as Gastrografin, prune juice, and acetylcysteine.

Conclusions

SAP beads pose significant risk in children. Hyperosmolar agents and osmotic laxatives may present a therapeutic option by reducing bead size, potentially averting the need for surgical intervention in the setting of SAP-induced bowel obstruction.